A collection of videos relating to the diagnosis and treatment of eye movement disorders. This collection includes many demonstrations of examination techniques.
Dan Gold, D.O., Associate Professor of Neurology, Ophthalmology, Neurosurgery, Otolaryngology - Head & Neck Surgery, Emergency Medicine, and Medicine, The Johns Hopkins School of Medicine.
A collection of videos relating to the diagnosis and treatment of eye movement disorders.
NOVEL: https://novel.utah.edu/
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Filters: Collection: "ehsl_novel_gold"
| Title | Description | Subject | ||
|---|---|---|---|---|
| 226 |
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Vibration-Induced Nystagmus in a Patient with Vestibular Neuritis | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a 60-year-old man who experienced the sudden onset of vertigo, oscillopsia, imbalance, nausea and vomiting. He was seen in the emergency department within hours and had spontaneous right-beating (RBN) and torsiona... | Jerk Nystagmus; Vestibular Nystagmus; Eighth Cranial Nerve; Acute Vestibular Syndrome |
| 227 |
 |
Visual Sensitivity | ||
| 228 |
 |
Voluntary Ocular Flutter | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a 45-yo-man with intermittent complaints of horizontal oscillopsia for 1 year. On examination, all classes of eye movements were normal, and neurologic examination was normal. MRI of the brain had been performed p... | Abnormal Convergence; Flutter; Voluntary Nystagmus; Voluntary Ocular Flutter |
| 229 |
 |
Wall-eyed Bilateral INO in Caudal Midbrain Lesion | This is a 30-yo-woman with the relatively acute onset of diplopia. There was a large angle exotropia, very subtle lag of the adducting saccades OD>OS, suggestive of bilateral INOs. This was best seen with rapid horizontal saccades, and a lesion involving bilateral MLFs in the caudal midbrain was dem... | INO; Abnormal Saccades; Jerk Nystagmus; Gaze Evoked Nystagmus |
| 230 |
 |
Wall-eyed Bilateral Internuclear Ophthalmoplegia (WEBINO) in MS | This is a young woman with a years-long history of multiple sclerosis who presented 2 years prior to this examination with complaints of oscillopsia (which was due to spontaneous upbeat nystagmus), as well as diplopia (which was due to bilateral internuclear ophthalmoplegia, INO). ; ; At the time of... | |
| 231 |
 |
Wallenberg Syndrome in MS | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: 30-yo-woman with MS presenting with acute vertigo and vertical diplopia. Examination demonstrated several aspects of the Wallenberg syndrome (her acute demyelinating lesion was in the left lateral medulla): ipsilesional (... | Vestibulo-ocular Reflex; Head Impulse Testing; Abnormal Alignment; Lateropulsion; Wallenberg Syndrome; Medulla; Vestibular Nystagmus; Skew Deviation |
| 232 |
 |
Wrong Way Nystagmus - Cranial Nerve 7 and 8 | ||
| 233 |
 |
A 'Canal Jam' During Head Impulse Testing in a Patient With Horizontal Canal BPPV | A 70-year-old man reported brief episodes of positional vertigo. Ten years prior, he had undergone gamma knife radiosurgery for a vestibular schwannoma at the left cerebellopontine angle. Video head impulse testing (vHIT) showed reduced gains and corrective saccades in the planes of the left horizon... | Jerk Nystagmus; PC BPPV; HC BPPV Diagnosis; Vestibular Nystagmus; Eighth Cranial Nerve; Vestibulocochlear Nerve |
| 234 |
 |
A Comparison of Nystagmus and Saccadic Intrusions/Oscillations | Nystagmus can be classified into pendular and jerk waveforms, where both are generated by a slow, pathologic phase. Corrective phase (the position reset mechanism) differs. In pendular nystagmus, the eyes move back and forth with about the same velocity and amplitude, similar to that of a pendulum... | Jerk Nystagmus; Flutter; Pendular Nystagmus; Square Wave Jerks; Opsoclonus |
| 235 |
 |
Active Head Impulse Test | Active head impulse test (HIT): instruct the patient to fix their eyes on the camera and turn their head 20o to the right/left, and then make a rapid movement toward the midline to align their head with the camera again, keeping their eyes fixed on the camera throughout. A simple instruction is to a... | Active Head Impulse Test |
| 236 |
 |
The Acute Vestibular Syndrome with Dysarthria, Dysphagia, Dysphonia, Hemi-ataxia, and Saccadic Dysmetria Due to the Lateral Medullary (Wallenberg) Syndrome | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a 50-year-old woman with the acute onset of vertigo, dysarthria, dysphagia and dysphonia/hoarseness (nucleus ambiguus), ptosis and imbalance. Her examination localized to a left lateral medullary (Wallenberg) synd... | Acute Vestibular Syndrome; Ninth Nerve; OMS Medulla; Abnormal Saccades; Tenth Nerve; Lateropulsion; Horner Syndrome |
| 237 |
 |
The Acute Vestibular Syndrome with Skew Deviation, Gaze-evoked Nystagmus, and Bilaterally Abnormal Head Impulse Testing Due to AICA Stroke | This is a 60-year-old man with the acute onset of prolonged vertigo and nystagmus, consistent with the acute vestibular syndrome (AVS). HINTS (Head Impulse, Nystagmus, Test of Skew) exam demonstrated a central pattern: 1) Head impulse test (HIT) was abnormal to the right and to the left. An abnormal... | Abnormal VOR-HIT; Abnormal Alignment; Skew; Jerk Nystagmus; Gaze Evoked Nystagmus; Acute Vestibular Syndrome; Seventh Nerve; OMS Pons; OMS Cerebellar |
| 238 |
 |
Assessing for Hyperventilation-induced Nystagmus | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: Hyperventilation induced nystagmus is tested by asking the patient to take quick deep breaths (~1/s) for 40-60 seconds. This decreases ICP and increases CSF pH. This can be helpful in diagnosing irritative conditions of ... | Hyperventilation |
| 239 |
 |
The Bedside Examination of the Ocular Motor System | A masterclass covering the bedside examination of the ocular motor system. | Ocular Motor Examination; Ocular Motor System |
| 240 |
 |
Bilateral 6th Nerve Palsies Due to Idiopathic Intracranial Hypertension | This is a 25-year-old woman who presented with diplopia and blurry vision. On exam, she was found to have papilledema and bilateral 6th nerve palsies. Her opening pressure was >40 cm of water with a normal CSF analysis, and neuroimaging was unremarkable aside from subtle findings that have been asso... | Sixth Nerve Palsy; Abnormal Range |
| 241 |
 |
Bilateral riMLF Syndrome Causing Vertical Saccadic Palsy and Loss of Ipsitorsional Fast Phases | This is a 60-year-old man who developed fatigue and diabetes insipidus about 12 months prior to this video, and MRI demonstrated hypothalamic enhancement at that time. Nine months prior to this video, he gradually noticed that he was unable to look down. Work-up for ischemic, infectious, inflammator... | Midbrain OMS; Downgaze Palsy; Upgaze Palsy; Vertical Gaze Palsy; Abnormal Saccades; Normal Pursuit |
| 242 |
 |
Bruns Nystagmus (During Video-Oculography) Due to Vestibular Schwannoma | A 25-year-old man with a history of right-sided hearing loss, headaches and imbalance was found to have a right vestibular schwannoma on MRI, and underwent a partial resection and radiotherapy. He denied symptoms of head movement dependent oscillopsia (i.e., suggestive of significant unilateral or b... | Jerk Nystagmus; Gaze-Evoked Nystagmus; Vestbular Nystagmus; Eighth Cranial Nerve; Vestibulocochlear Nerve; Cerebellar OMS |
| 243 |
 |
Caloric Testing | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: Caloric testing is a peripheral vestibular test which takes advantage of the fact that the labyrinth is sensitive to temperature changes. Warm stimulation causes excitation of the semicircular canals while cold stimulatio... | Normal VOR; Abnormal VOR; Vestibular Lab Testing; Calorics |
| 244 |
 |
Centripetal Nystagmus Example | A 68-year-old female reported a 2-year history of progressive gait imbalance, falls, dizziness and vertical oscillopsia. She described that dizziness and oscillopsia were worst when looking down. There was no family history of ataxia. Composite gaze with fixation was recorded with video-oculography ... | Gaze-evoked Nystagmus; Rebound Nystagmus; Centripetal Nystagmus; Cerebellar Degeneration |
| 245 |
 |
Convergence | Convergence: instruct the patient to focus on their thumb held at arm's length, and slowly move their thumb towards their nose. This may bring out or cause reversal of vertical nystagmus (e.g., transition from upbeat to downbeat nystagmus in Wernicke's encephalopathy [see example of transition from ... | Convergence |
| 246 |
 |
Demonstration of HINTS Examination in a Normal Subject | In the acute vestibular syndrome - consisting of acute prolonged vertigo, spontaneous nystagmus, imbalance, nausea/vomiting, head motion intolerance which is typically due to vestibular neuritis or posterior fossa stroke - a 3 step test of ocular motor and vestibular function known as HINTS, has hig... | Acute Vestibular; Normal VOR; Vertigo; HINTS examination |
| 247 |
 |
Dix-Hallpike | The safety of the patient should be prioritized when completing this test virtually, and the examiner should avoid putting the patient in a position where a fall may occur. Floor (or bed) Dix-Hallpike: this test can be used for patients who are fully mobile and able to get down to the floor and up a... | Dix-Hallpike |
| 248 |
 |
Dynamic Visual Acuity | Dynamic Visual Acuity: the examiner can use screen-sharing to provide a visual acuity chart. Instruct the patient to sit at the appropriate distance from their screen at which the lowest line on the visual acuity chart is just readable. Have the patient move their head (horizontally to evaluate the ... | Dynamic Visual Acuity |
| 249 |
 |
Dynamic Visual Acuity | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: After assessing static binocular visual acuity, dynamic visual acuity (DVA) is determined by repeating the test during horizontal and vertical head shaking at 2-3 Hz. Dynamic visual acuity is most important to test when ... | Dynamic Visual Acuity |
| 250 |
 |
ENG, VNG, & VOG | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: Electronystagmography (ENG), and videonystagmography (VNG) or videooculography (VOG) are a collection of tests of eye movements that are performed either using surface electrodes around the eye (ENG) or with video goggles... | Vestibular Lab Testing; ENG, VNG, & VOG |